The Art of Self-Care

Prior to the COVID-19 pandemic, mental health issues and drug use was increasing in the United States. The National Survey on Drug Use and Health [1], found that 47.6 million (19.1%) adults aged 18 years or older reported at least one mental illness in 2017- 2018, and over 11.4 million (4.6%) suffered a serious mental illness that impacted daily functioning. The survey found that nearly 10.7 million adults (4.3%) had suicidal thoughts, 3.3 million (1.3%) made plans to kill themselves, and 1.4 million (0.6%) made a nonfatal attempt. Over 48,000 people followed through on their threat and died [2]. In 2018, an estimated 164.8 million people (60.2%) aged 12 years or older used substance such as tobacco, alcohol, illicit drugs, or misused prescription pain medication [3]. Wilson et al. [4], reported that there were 67,367 drug overdoses in the U.S. and of these, 46,802 (69.5%) was caused by opioid misuse. As the pandemic continues to stretch health services to the limit for treatment of physical symptoms of the disease, the mental health toll has yet to be calculated.

Javed et al. [5], highlighted the risks of social distancing, selfisolation, and preventative measure imposed to stop community spread. These included the risks to children and teens when daily routines were disrupted, adverse effects on older adults and those with disabilities, additional pressures on health care workers, and the stigma attached to the disease. In Czeisler et al. [6], survey conducted between June 24-30, 2020, participants reported mental health issues such as anxiety and depression, trauma or stressed induced symptoms, and increased substance use related to the pandemic. With limited access to services for existing health needs and the fear of catching the disease for those with underlying conditions, feelings of isolation, loneliness, and disconnection with self and others can only be exacerbated. Add in the financial pressures of lost revenue or jobs through lockdowns and closing of businesses, all aspects of daily life and living has been impacted by the pandemic. These symptoms can only increase as the pandemic rages on and the death toll mounts.

Panchal et al. [7], reported that front line workers including those in healthcare face the additional risk of burnout from these stressors as they deal with their own life issues and concerns for their own families as well as provide support and services for others. Which is why self-care is very important to mitigate these risks. Besides following CDC guidelines regarding health and safety during this pandemic, daily activities that reduce anxiety levels and improve mood states can be done at home to increase coping skills and improve mental health. Stuckey and Nobel [8], investigated literature on four areas of creative expression (music, visual arts, movement-based creative expression, and expressive writing). The researchers found that engaging in creative activities helped to decrease symptoms of anxiety, stress, and mood disturbances. Martin [9], systematic review of Creative Arts Therapy literature from 1980-2016 concluded that while more empirical research was recommended, there was evidence that engaging in creative activities had a positive effect on participants. Mood-creativity research indicates that there was a correlation between positive mood states that were focused and engage participant’s motivation towards a specific goal [10,11]. These results were supported by Han et al. [12], study that indicated that specific goals such as increasing feelings of happiness, concentration, being active, and interested resulted in increased creativity, while low-activity and negative mood states were associated with feeling tired and sleepy.

Developing daily rituals and engaging in mindfulness and creative activities can help to reduce stress and increase positive mood states. Suggested activities include:

1. Creating rituals. Whether rituals were as simple as making a cup of tea (or coffee) or preparing for the day, they can be important in bringing attention and focus to the moment. Rituals have been around for generations and across cultures. Fiese et al. [13], found that simple family rituals helped to bring members together, improved parenting, and child interactions, and helped to define what was important to the family unit.
2. Creative a stimulating environment through color, sounds, smells, textures etc. and a sacred space at work or at home can help provide a safe place from which to recover from the trials of the day [14]. Whether it is a room, a shed, a balcony, or a corner, inside or outside, making a space can help nurture creativity and provide a sanctuary.
3. Daily gratitude and focusing on being thankful and appreciating what is working can help provide meaning in difficult circumstances [15]. Keeping a journal that includes words of gratitude, positive affirmation, or inspiring poem can help to increase life satisfaction.
4. Mindfulness activities include deep breathing exercises, meditation, yoga, and movement. Whether it is keeping a food or drink diary to control unwanted behaviors such as emotional eating or self-medication, being mindful and in the moment can halt negative impulses. Howarth et al. [16], found that even brief mindfulness practices resulted in positive health outcomes in their systematic review of the literature.
5. Activating your creativity. Whether its music, art, dance/ movement, creative writing, or any other form of expression, make time during the day or week for a creative activity. Engaging in these activities can increase self-expression, selfdiscovery, and reconnect to social identity [17]. Mix up your creative expressions by painting to music, dancing to art, putting movement to words, or dancing to your favorite songs. Make art with found objects or recycled materials. The important thing is making the time for you and incorporating creativity into selfcare practices.

In a period of transition, it can be easy to lose one’s way. Worrying about things that you have no power to change will only increase frustration and anger. The pandemic is causing worldwide suffering. We are not alone in this. It is important to take care of yourself first before you can help others. Which is why self-care is very important and the number one priority for those working in health care and on the front lines of the battle to contain COVID-19. Keep it simple. Focus on one goal each day. Slow down and take a walk, work in the garden, or plant some seeds and watch them grow. Bring a little order into the chaos and uncertainty and make space to reflect on what is important. Re-evaluate, de-clutter, organize, and schedule your time. Let go of things you cannot control. Embrace your creativity and allow it to be part of healing for self and others. Above all, have fun, explore, and create!

None.

Author declare no conflict of interest.

The author is an Assistant Professor at West Liberty University (WLU) and teaches undergraduate creative art therapy courses and is in the process of developing a graduate Art Therapy and Counseling program at WLU. In her practice, she has used a wide range of modalities including talk therapy and a variety of expressive arts including the use of art materials to elicit emotional and psychological responses, movement, music, drama, and play therapy. She is a Board-Certified Art Therapist (ATR-BC), a Registered Expressive Arts Therapist (REAT), and a Nationally Certified Counselor (NCC).

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